Borneo Epidemiology Journal

NEWBORN HEARING SCREENING IN BORNEO INTERIOR ZONE: PRIME CASE IN KENINGAU

Doh Jeing Yong, Ridwan Hashim, Hui Lian Ho — Tue, 18 Nov 2025 00:00:00 +0800

Borneo Sabah being part of the country of Malaysia, is constituted by huge land area. Healthcare development in rural area of interior always lags behind the city area. Wise distribution of healthcare personnel and equipment are possible and should be looked in as an important step to escalate heath care accessibility of the under privileged folks. Neonatal hearing screening is not available in the interior of Sabah. This study describes the first case of newborn hearing screening conducted at Keningau Hospital, an interior zone of Northern Borneo, Malaysia. New service of high-risk neonatal hearing screening was launched and protocol of neonatal Otoacoustic Emission (OAE) screening was established.

NAVIGATING THE DIGITAL HEALTH RECORD: BARRIERS TO ELECTRONIC MEDICAL RECORDS IMPLEMENTATION IN SOUTHEAST ASIA: A NARRATIVE REVIEW

Thu, 28 Aug 2025 00:00:00 +0800

Traditional paper-based medical records face multiple limitations, including poor standardization and inefficiency in data retrieval. Electronic Medical Records (EMRs) offer solutions to these limitations and are key to healthcare digitalization. However, EMRs implementation remains inconsistent across Southeast Asia due to varied systemic and contextual barriers. A narrative review was conducted using three databases (PubMed, Scopus, and ScienceDirect) to identify peer-reviewed articles published between 2008 and 2023. Search terms included “Electronic Medical Records,” “EMR,” and “Southeast Asia.” Inclusion criteria focused on studies describing the implementation challenges of EMRs in Malaysia, Indonesia, Vietnam, and Thailand. A total of 22 relevant articles were included. No formal quality appraisal was conducted due to the narrative nature of the review. Several barriers to implementation EMRs were identified such as high initial investment costs, limited IT infrastructure, lack of skilled personnel, resistance to technology adoption, data security concerns, and fragmented governance. While some countries, such as Malaysia and Vietnam, have national frameworks in place, challenges persist in rural access, interoperability, and policy enforcement. Despite growing interest and partial progress in EMRs adoption, Southeast Asian countries face systemic and logistical challenges that hinder full implementation. Coordinated regional strategies, greater investment in capacity building, and strong governance are essential for sustainable digital health transformation in the region.

A REVIEW OF HEALTH INFORMATION SYSTEMS IN MALAYSIAN PUBLIC HOSPITALS: CURRENT PRACTICE, BENEFITS, AND BARRIERS

Tue, 05 Aug 2025 00:00:00 +0800

Hospital Information System (HIS) is one of the important pillars in current healthcare system practice worldwide. The study initiated after a review revealed a scarcity of applications and studies on HIS in Malaysia’s public hospital setting. This scoping review aims to explore the current practice, benefits, and barriers associated with Health Information Systems (HIS) in Malaysian public hospitals. Utilizing the PRISMA guidelines, relevant literature was sourced from the SCOPUS database, focusing on publications from 2012 to 2022. A total of nine studies were selected for analysis. The review reveals that, despite being introduced early, the implementation and utilization of HIS in Malaysian public hospitals remain limited and slow. HIS offers substantial benefits, including improved clinical documentation, administrative efficiency, and enhanced quality and coordination of care. However, several barriers hinder its successful implementation, categorized into five main areas: financial, organizational, behavioral, technological, and support-related. Addressing these challenges is essential for realizing the full potential of HIS in improving patient care and hospital efficiency. This review serves as a baseline for identifying critical issues and guiding future improvements in Malaysia's public healthcare sector.

BEYOND BARRIERS: ENHANCING ABORTION CARE IN SOUTHEAST ASIA

Nabilah Ayob, Sharina Mohd Shah, Khalid Mokti — Mon, 22 Dec 2025 00:00:00 +0800

WHO estimates show that 45% of abortions globally are unsafe and responsible for up to 13 % of maternal deaths, a burden that is disproportionately high in regions with restrictive abortion law such as developing regions like Southeast Asia. Our scoping review explores the knowledge, attitudes, practices (KAP), barriers, and limitation related to abortion care in Southeast Asia from 2019 to 2023. This review was conducted following PRISMA-ScR guidelines. Articles published between 2019 and 2024 were identified using PubMed, ScienceDirect, Scopus, and Google Scholar. Inclusion criteria focused on studies from Southeast Asia addressing abortion care, including PAC, with qualitative, cross-sectional, cohort, or intervention designs. Data were synthesized descriptively by themes such as KAP, barriers, and policy implications. From 584 identified records, 11 studies met inclusion criteria. Findings revealed significant knowledge gaps among healthcare providers and the general population, influenced by cultural and religious stigmas. Support for abortion was higher in medically critical situations than for socio-economic reasons. Barriers included stigma, legal restrictions, and inadequate training. Findings emphasize the importance of addressing cultural and systemic barriers, enhancing provider training, and incorporating PAC into primary healthcare systems. Global practices, such as telemedicine in China and mid-level provider training in Ethiopia, provide valuable models for Southeast Asia. To improve PAC access and quality in Southeast Asia, culturally sensitive, decentralized, and collaborative approaches are essential. Governments, healthcare systems, and communities must work together to ensure equitable and inclusive reproductive health services.

CLOSING THE IMMUNITY GAP: A NARRATIVE REVIEW ON IMPROVING HEALTHCARE WORKER PERTUSSIS VACCINATION IN MALAYSIA THROUGH LESSONS FROM THE GLOBAL EXPERIENCE

Mon, 22 Dec 2025 00:00:00 +0800

Pertussis remains a significant public health concern despite widespread vaccination programs, with healthcare workers (HCWs) increasingly recognised as both susceptible populations and potential sources of nosocomial transmission to vulnerable infants. While many high-income countries have established comprehensive HCW pertussis vaccination policies, Malaysia lacks formal national guidelines despite documented infant pertussis burden. This narrative review examines global healthcare worker pertussis vaccination policies and their applicability to Malaysia, evaluating evidence on nosocomial transmission, vaccination strategies, cost-effectiveness, and policy implementation. A narrative review was conducted in accordance with established guidelines for literature synthesis. Multiple databases, including PubMed, Scopus, and Web of Science, were searched for peer-reviewed literature on pertussis vaccination policies, nosocomial outbreaks, HCW immunisation strategies, and economic evaluations. Grey literature from government health agencies was included to capture policy documents. Healthcare workers demonstrate substantial pertussis susceptibility globally, with seroprevalence studies showing 48.3-51.7% lacking protective immunity. Documented nosocomial outbreaks indicate a significant risk of transmission to vulnerable infants. International policies vary considerably: Australia, the United Kingdom, and Canada mandate or strongly recommend Tdap vaccination for HCWs as part of occupational health programs, while Malaysia lacks specific HCW vaccination guidelines. Cost-effectiveness analyses show that HCW vaccination programs yield net savings of $17.84 per dollar spent when productivity losses are included. Substantial evidence supports the implementation of mandatory Tdap vaccination policies for Malaysian healthcare workers. Recommendations include establishing national HCW vaccination guidelines, providing free workplace vaccination programs, and implementing pre-employment vaccination requirements.

MATERNAL CHALLENGES AND STRATEGIES IN COMBATING CHILD MALNUTRITION IN RURAL COMMUNITIES: A NARRATIVE REVIEW

Mohamad Kamal Mohamed Lazi , Woon Fui Chee — Tue, 04 Nov 2025 00:00:00 +0800

Child malnutrition remains a persistent global problem despite numerous nutrition initiatives, especially in rural and underserved settings. Many interventions overlook the central role of mothers whose ability to ensure adequate child nutrition is constrained by limited health literacy, socio-cultural norms, and economic barriers. This narrative review examines the influence of maternal health literacy, socio-cultural norms, economic constraints, and support networks on child malnutrition in underserved communities. This narrative review synthesized evidence from studies published between 2020 and 2024 retrieved from PubMed, Scopus, Web of Science, and Google Scholar to identify maternal barriers and facilitators influencing child nutrition in rural contexts. Mothers play a pivotal role in child health, yet factors like limited autonomy, financial hardships, and inadequate support systems hinder their ability to combat malnutrition. Research indicates that low maternal health literacy is associated with poorer nutrition outcomes, emphasizing the need for targeted education programs. Economic barriers limit access to diverse and nutritious foods, while socio-cultural norms shape caregiving practices, either facilitating or restricting maternal efforts. Effective interventions should incorporate community-driven support, economic empowerment, and culturally tailored education to strengthen maternal capacity and improve child nutrition outcomes.

WILLINGNESS TO PAY FOR OUTPATIENT SERVICES: A NARRATIVE REVIEW

Mon, 22 Dec 2025 00:00:00 +0800

The concept of Willingness to Pay (WTP) in healthcare refers to the maximum amount an individual is willing to pay for a particular health service for outpatient (OP) services. WTP studies provide valuable insights into patients' preferences, perceived value of care, and ability to contribute financially to their healthcare. Hence, it assists in informed decision-making and policy formulation, potential strategies for cost-sharing, resource allocation, and service improvement, determine appropriate pricing strategies and identify potential barriers to the access. This narrative review aims to synthesize the current literature on WTP for OP services, exploring the factors that influence patients' WTP and the implications for healthcare policy and practice. Total of 13 articles reviewed across the global related to WTP for OP Services between 2014 and 2024. Prevalence of WTP for OP services varies across different countries and healthcare settings. Factors influencing WTP for OP services include sociodemographic factors, economic factors, health-related factors, health insurance coverage, type and quality of healthcare, accessibility, type of healthcare provider, and past experiences with healthcare services. WTP analysis helps identify and prioritize investments in service that tailored with patient needs to enhance the quality of care. This review highlights important lessons for healthcare financing and equity. If it reveals that by providing concrete data on the factors influencing WTP for OP services in the local setting, the research can drive evidence-based policy decisions.

REPRODUCTIVE AGING AND MENOPAUSAL TRANSITION IN MALAYSIA: PUBLIC HEALTH AND POLICY STRATEGIES FOR ENHANCING WOMEN’S QUALITY OF LIFE

Thirumurugan Nyanasegram, Khalid Mokti — Mon, 22 Dec 2025 00:00:00 +0800

Reproductive aging and the menopausal transition represent significant public health challenges that affect millions of women globally and in Malaysia. By 2030, more than 1.2 billion women worldwide will be menopausal, yet healthcare systems remain insufficiently prepared to address the health, social, and economic implications. This narrative review synthesizes recent evidence (2020-2025) on the epidemiology, challenges, and strategies for improving women’s quality of life during menopause, with a focus on Malaysia. Key findings show that the average age of menopause varies globally, ranging from the 47 years in South Asia to 51 years in high-income countries, with early menopause increasingly reported in low- and middle-income regions. Health consequences include osteoporosis, cardiovascular disease, metabolic syndrome, and mental health disorders, compounded by social stigma and inadequate workplace and healthcare support. Public health challenges in Malaysia include limited awareness, lack of provider training, and underfunded menopausal services. Strategies to address these issues involve education campaigns, integration of menopause into primary healthcare, workplace accommodations, lifestyle and preventive interventions, and digital health solutions such as mobile applications and telemedicine. International examples, including UK Menopause Taskforce and WHO’s Health Aging framework, provide valuable lessons for Malaysia. However, digital health interventions face challenges related to access, affordability, and data privacy. This review emphasizes the need for culturally sensitive, evidence-based, and policy-driven approaches to strengthen menopausal health services in Malaysia. Future research should evaluate digital health tools, cross-cultural experiences, and long-term health outcomes to guide policy and practice.

A NARRATIVE REVIEW OF TELEHEALTH SERVICE SUCCESS AND SUSTAINABILITY IN RURAL HEALTHCARE SETTINGS

Wed, 30 Jul 2025 00:00:00 +0800

Telehealth services have emerged as a promising solution to address healthcare disparities, improving access to care, reducing costs, and enhancing patient outcomes. This review explores the potential of telehealth in improving healthcare access, as well as the factors leading to its success and sustainability. Examining the promise and constraints of telemedicine adoption provides insights into the broader possibility and implications of telehealth technologies. A narrative review analysed 12 English-language literatures (2019-2023) from PubMed, Science Direct, Scopus, ProQuest, and Emerald Insight, focusing on telehealth data, regulations, success factors, and rural access. Telehealth offers significant benefits, particularly in improving access to healthcare for rural and underserved populations, reducing travel time and costs, and enhancing patient engagement. It also aids in early disease detection and management, leading to better patient outcomes and reducing unnecessary hospital admissions. However, challenges remain, especially in technological infrastructure, where inadequate internet connectivity in rural areas hampers effective implementation. Patient satisfaction depends on convenience, efficiency, privacy, and communication, all of which can be compromised by technical issues. Six critical factors for telehealth success include vision, ownership, adaptability, economics, efficiency, and equipment, which must be addressed for sustainable adoption, particularly in rural settings. Despite the potential of telehealth services to revolutionize healthcare access, challenges such as funding limitations, infrastructure barriers, and concerns about the quality of telemedicine encounters persist. For telehealth services to be successful and sustainable in the long run, several issues must be resolved. Strategies include enhancing infrastructure, ensuring adherence to regulations and guidelines, and fostering awareness and acceptance among healthcare professionals and patients. The results highlight the necessity of ongoing investigation, assessment, and strategic planning to fully realize the promise of telehealth services, particularly concerning cancer treatment and other crucial areas of healthcare.

ADDRESSING THE DUAL BURDEN OF SEXUALLY TRANSMITTED INFECTIONS (STI) AND HIV/AIDS IN MALAYSIA: A NARRATIVE REVIEW

Edwin de Cruz, Azman Atil, Khalid Mokti — Fri, 19 Dec 2025 00:00:00 +0800

Malaysia has achieved notable success in HIV/AIDS prevention, including the elimination of mother-to-child transmission and widespread availability of antiretroviral therapy (ART). However, significant challenges persist in addressing the dual burden of sexually transmitted infections (STIs) and achieving the 95-95-95 HIV cascade targets. This narrative review aims to synthesize evidence on the barriers and facilitators of STI and HIV/AIDS prevention in Malaysia, emphasizing sociocultural and systemic factors within a family health context. A thematic synthesis was conducted using literature retrieved from databases including PubMed, ScienceDirect, and Scopus to explore constraints and innovative strategies. Key findings demonstrate that cultural norms and religious beliefs perpetuate stigma, hindering access to care and education, particularly for key populations such as men who have sex with men (MSM) and transgender individuals. Systemic issues, including pervasive healthcare worker bias, late HIV diagnoses (68% in 2023), and privacy concerns surrounding digital health tools, further constrain progress. Framing these issues within family health reveals profound financial, emotional, and intergenerational impacts. By addressing these deep-rooted cultural and systemic barriers through evidence-based, inclusive strategies, Malaysia can accelerate progress toward its 2030 goal of ending AIDS and reducing the STI burden.

FROM FOREST TO FAST FOOD: NUTRITION AND LIFESTYLE TRANSITIONS IN SABAH

Edwin de Cruz, Khalid Mokti, Azman Atil — Fri, 19 Dec 2025 00:00:00 +0800

Indigenous communities in Sabah, Malaysia, are undergoing a rapid nutrition transition, shifting from traditional, nutrient-dense diets to modern, processed food consumption. This transition, driven by factors like urbanization, economic shifts, and environmental degradation, is profoundly affecting health outcomes. Data from the National Health and Morbidity Survey (NHMS) reveals that overall obesity rates in Malaysia increased from 17.7% (in 2015) to 19.7% (in 2019), with indigenous groups experiencing a disproportionate burden of non-communicable diseases (NCDs). This paper synthesizes current research on dietary shifts, rising NCD prevalence, and socioeconomic determinants among Sabah's indigenous populations, focusing on the coexistence of undernutrition and rising obesity (the double burden of malnutrition). We argue that addressing these complex challenges requires urgent, culturally tailored public health interventions that promote traditional diets, enhance food security, and integrate indigenous knowledge with modern health strategies.

DETERMINANTS OF MEDICAL DOCTORS LEAVING MALAYSIA’S PUBLIC HEALTHCARE SECTOR: A NARRATIVE REVIEW

Fri, 12 Sep 2025 00:00:00 +0800

The exodus of medical doctors from Malaysia’s public healthcare sector has become a pressing concern, with an average of 3.5 doctors resigning daily between 2019 and 2023. This narrative review explores the determinants of medical doctors leaving Malaysia’s public healthcare workforce, based upon literatures published from the past 2 decades. Literature search was conducted across five databases. From the 25 identified articles, five main themes were synthesized: “Career Advancement & Job Security”, “Professional Recognition & Work-Life Harmony”, “Workplace Culture, Environment & Support”, “Staff Welfare” and “Staff Emoluments”. Contributing key factors include limited opportunities for career progression, job insecurity among contract doctors, attractive private sector offers with significant salary disparities between public and private sectors, poor workplace conditions with heavy workload, inadequate emotional and psychological support. Additionally, bureaucratic inertia with lack of autonomy, and burden in balancing clinical and administrative responsibilities have strained medical professionals. In addressing these challenges to retain medical doctors in the public healthcare workforce, it is pertinent to improve career advancement opportunities, enhancing workplace support systems and culture while reducing workload, and also addressing salary disparities. Thusly ensuring the Malaysian public healthcare workforce being more resilient and sustainable, assuring provision of quality healthcare services to the population.

THE GLOBAL PLAYBOOK FOR TOBACCO CONTROL POLICY: CHALLENGES, STRATEGIES, AND A CASE STUDY FROM MALAYSIA

Thu, 31 Jul 2025 00:00:00 +0800

Tobacco use remains a leading cause of preventable death globally, disproportionately affecting low- and middle-income countries (LMICs). Despite the implementation of the WHO MPOWER strategy, significant challenges persist, including the high prevalence of smoking among lower socioeconomic groups and the rapid emergence of e-cigarettes, particularly among youth. This narrative review explores the contemporary challenges in tobacco control, outlines effective strategies, and analyzes Malaysia's policy alignment with global recommendations to guide future interventions. A literature search was conducted in May 2025 across the Scopus, PubMed, and Cochrane Central databases. The search focused on articles published in English within the last 15 years, using keywords related to the challenges (e.g., "policy resistance," "enforcement problems") and strategies (e.g., "taxation," "cessation programme") of tobacco and e-cigarette control policy. All study designs were considered, while editorials and presentations were excluded. The review identifies two primary areas. First, key challenges to tobacco control include significant socioeconomic disparities in nicotine dependence, aggressive marketing targeting vulnerable populations, regulatory gaps concerning synthetic nicotine and novel products, and industry interference through legal challenges and manipulation of international trade policies. Second, effective strategies are categorized across three levels: macro (comprehensive taxation, product regulation), meso (community-based initiatives, pictorial health warnings), and micro (individual-level interventions like incentive programs and pharmacological support). Effective tobacco control demands a multi-layered, equitable approach that integrates robust policy with community and individual support. By enacting the Control of Smoking Products for Public Health Act, Malaysia has taken a positive step, but further action is crucial. Key future priorities include: 1) enhancing and harmonizing fiscal and legal measures through international collaboration to prevent industry forum-shopping; 2) sustaining investment in public education to reduce initiation and normalize cessation; and 3) advancing targeted research on cessation supports, especially for LMICs.

CHALLENGES OF DENGUE CONTROL AND PREVENTION WORLDWIDE: A SYSTEMATIC REVIEW

Tue, 04 Nov 2025 00:00:00 +0800

Dengue fever is a mosquito-borne disease representing significant public health challenges worldwide. Management of dengue prevention and control faces numerous challenges, including rapid urbanization, climate change, and socioeconomic inequalities. This systematic review aims to determine the challenges of the dengue control and prevention strategies. This review conducted a comprehensive search of articles published from 2013 to 2024, utilizing databases such as Scopus, ScienceDirect, and PubMed. The Preferred Reporting Items for Systematic Reviews (PRISMA) are used to improve transparency and completeness of reporting, and the Joanna Briggs Institute (JBI) is used for critical appraisal. The findings from the risk of bias assessment revealed moderate to high quality across the studies, with scores ranging from 5 to 9 out of 10. The populations studied included community members, health officers, healthcare workers, caregivers, and health surveillance experts representing diverse geographic locations like Malaysia, Thailand, the Dominican Republic, and Brazil. The types of studies included were qualitative, with one case report. Major challenges identified include weak community participation, inconsistent stakeholder coordination, socioeconomic constraints, and environmental factors affecting vector control sustainability. Integrated strategies combining traditional and innovative approaches, with strong community involvement and inter-sectoral collaboration, are essential for sustainable dengue control. In conclusion, the management of dengue needs integrated strategies that combine traditional methods with innovative approaches. In addition, it is crucial to involve the community and coordinate with stakeholders to enhance the effectiveness of dengue control measures by adapting to the local context. Future research should focus on developing sustainable and community-driven interventions, as well as enhancing inter-sectoral collaboration to address the multifaceted challenges of dengue prevention and control.

RISING TEMPERATURES, RISING CHALLENGES: A NARRATIVE REVIEW ON STRENGTHENING CHILD GROWTH MONITORING SYSTEMS AMID CLIMATE VULNERABILITY

Edwin de Cruz, Khalid Mokti, Azman Atil — Thu, 18 Dec 2025 00:00:00 +0800

Climate change presents an unprecedented challenge to child growth monitoring systems, with vulnerable populations disproportionately affected by malnutrition, health system disruptions, and displacement. This narrative review synthesizes evidence on the impacts of climate change on child health and explores adaptive strategies, including digital health innovations, community-based interventions, and policy responses. Case studies from climate-vulnerable regions highlight the importance of integrating growth monitoring into broader climate resilience frameworks. Recommendations include strengthening multi-sectoral collaborations, prioritizing equity in funding, and fostering community engagement to ensure sustainability. This review underscores the urgency of action to protect child health amid a changing climate.

ADDRESSING NON-COMMUNICABLE DISEASES IN MEN IN MALAYSIA: PROBLEMS AND CHALLENGES FROM PERSPECTIVE OF FAMILY HEALTH

Muhammad Suhail Abdul Wali, Khalid Mokti — Mon, 15 Dec 2025 00:00:00 +0800

Non-communicable diseases (NCDs) are becoming a serious issue for Malaysian men, affecting not just their health, but also the lives of their families. Many men delay seeking help because of social stigma and traditional views about masculinity, often making problems worse. Lifestyle factors like poor diet, lack of physical activity, and smoking further increase the risks. The aim of this review is to highlight how NCDs affect men in Malaysia, especially how these diseases impact families emotionally, financially, and through caregiving. By examining these connections, this review hopes to show why we need health policies and support systems that consider men’s unique challenges. Promoting more male-friendly healthcare, raising awareness, and encouraging family and community involvement could help more men act early, making families and communities healthier in the long run.

DIGITAL HEALTH: ADVANCES AND CHALLENGES

Lin Naing — Thu, 28 Aug 2025 00:00:00 +0800

Digital technology is rapidly transforming every sector of society, and the health sector is no exception. The integration of digital tools, ranging from mobile health (mHealth), telemedicine, applications to artificial intelligence (AI), big data analytics, and the Internet of Things (IoT), has led to the emergence of Digital Health as a new paradigm in population health management. This editorial discusses key advances and enduring challenges, finally ‘way forward’ in digital health development.

COST ANALYSIS OF SMOKING CESSATION PROGRAMME IN PUSAT RAWATAN WARGA, UNIVERSITI MALAYSIA SABAH

Tue, 04 Nov 2025 00:00:00 +0800

Despite ongoing tobacco control measures, data on the direct costs of local smoking cessation programmes in Malaysian tertiary educational settings remain scarce. This study evaluates the cost implications of nicotine replacement therapy (NRT) at Universiti Malaysia Sabah (UMS) Quit Smoking Clinic, focusing on 2 mg and 4 mg Nicorette gum dosages. A retrospective cost analysis using a bottom-up micro-costing approach was conducted at Pusat Rawatan Warga, UMS, in 2023. Twenty patients were enrolled in the programme: those receiving 2 mg gum (follow-up every two months) and those receiving 4 mg gum (follow-up monthly). Direct programme costs, including counselling sessions, annual blood tests, and daily Nicorette gum consumption, were calculated. The annual cost per patient was RM 3,249.67 for the 2 mg gum group and RM 4,860.33 for the 4 mg gum group, with a mean annual cost of RM 4,055.00. Cost variations were influenced by gum dosage strength, frequency of follow-ups, and associated clinical procedures. The study highlights the substantial financial requirements of operating a structured smoking cessation programme in a tertiary educational setting. Policymakers and healthcare planners may use this evidence to inform budgeting, optimize resource allocation, and evaluate the sustainability of smoking cessation services. Future research should assess the cost-effectiveness of different NRT dosages to guide policy on scaling up cessation programmes.

DEVELOPMENT AND VALIDATION OF A CULTURE-SPECIFIC FOOD FREQUENCY QUESTIONNAIRE AMONG PULMONARY TUBERCULOSIS PATIENTS IN SABAH, MALAYSIA

Khalid Mokti, Zaleha Md Isa — Mon, 25 Aug 2025 00:00:00 +0800

Accurate dietary assessment among populations with infectious diseases remains a challenge, particularly in culturally diverse and low-resource settings. This study aimed to develop and validate a region-specific Food Frequency Questionnaire (FFQ) to assess nutrient intake among patients with pulmonary tuberculosis (PTB) in Kota Kinabalu, Sabah, Malaysia. A semi-quantitative FFQ comprising 62 food items grouped into 13 categories was developed based on three-day 24-hour dietary recalls (24HR) from 41 newly diagnosed adult PTB patients. The FFQ was validated by comparing nutrient intake estimates with the mean values obtained from 24-hour recalls using Pearson correlation, energy-adjusted correlation, cross-classification, and intra-class correlation coefficient (ICC) analysis. Reproducibility was assessed by administering the FFQ twice, with a three- to five-week interval between administrations. Unadjusted Pearson correlation coefficients between the FFQ and 24HR ranged from 0.39 (carotene) to 0.90 (energy), with a mean of 0.66 ± 0.17. Energy-adjusted correlations ranged from 0.23 (niacin) to 0.76 (vitamin B1), averaging 0.55 ± 0.16. The proportion of participants classified into the same nutrient intake quartile ranged from 27% to 61%, while the proportion of extreme misclassification ranged from 5% to 24%. ICCs for reproducibility between FFQ1 and FFQ2 were high, ranging from 0.79 (vitamin C) to 0.99 (protein). We validated an FFQ specifically designed for Malaysian patients with pulmonary tuberculosis, providing a culturally relevant and reproducible dietary assessment tool. The FFQ showed strong correlation with reference recalls (mean Pearson r = 0.66), and excellent reproducibility (ICC range 0.79–0.99). It is particularly suited for epidemiological research examining the association between nutrition and TB treatment outcomes, and can inform future nutritional surveillance and targeted interventions in TB control programs.

COST ANALYSIS OF PHARMACY ON DELIVERY (POD) AND CONVENTIONAL COUNTER DISPENSING (CCD) IN PUSAT RAWATAN WARGA (PRW) UMS

Mon, 04 Aug 2025 00:00:00 +0800

As the demand for more efficient and accessible healthcare services grows, pharmacy services are evolving to better meet patient needs, offering distinct advantages and challenges in terms of cost, convenience, and accessibility. Pharmacy delivery, whereby one’s medicine being delivered to the comfort of their home or workplace, is one example of pharmacy services evolution, as compared to a standard dispensing at the clinic. This study aims to determine the cost differences between two pharmacy service models implemented at Pusat Rawatan Warga (PRW), Universiti Malaysia Sabah (UMS): Pharmacy On-Delivery (POD) and Conventional Counter Dispensing (CCD). This cross-sectional study was conducted at Pusat Rawatan Warga (PRW), Universiti Malaysia Sabah (UMS), over a two-week period. We analysed both fixed and variable costs associated with the Conventional Counter Dispensing (CCD) and Pharmacy On-Delivery (POD) services, with a particular focus on personnel and transportation expenses. Descriptive analysis was performed using Microsoft Excel to calculate means and standard deviations. The findings showed the cost of POD averaging RM6.55 per prescription compared to RM3.44 for CCD, while the time taken averaging 9.80 minutes per prescription for POD compared to CCD’s 5.69 minutes per prescription. The delivery process was the primary driver of the total time required for POD prescriptions, accounting for approximately 54% of the total time involved. Despite the higher costs, the popularity of POD has grown steadily, with its adoption increasing from 2.49% in 2022 to 6.70% in 2024. This study highlights the need to balance the higher operational costs of Pharmacy On-Delivery (POD) services with their benefits in enhancing medication adherence and convenience, especially for patients with chronic conditions. To support sustainability, strategic improvements such as optimizing delivery routes, using GPS-based tracking, and adopting computerized Hospital Information Systems (HIS) are recommended. These findings provide critical insights for improving the efficiency and cost-effectiveness of POD services at PRW, UMS, particularly in resource-limited healthcare settings.